Minimally invasive sliding hip screw insertion technique

Sliding hip screws (SHS) are commonly used for fixation of extra-capsular hip fractures, and there is increasing use of minimally invasive methods of insertion of such devices. We describe a case series of 579 consecutive patients operated on by the senior author using such a technique. Data were collected prospectively and analysed retrospectively. The technique involves a 5cm incision, retraction of vastus lateralis superiorly by a chain retractor, and use of a SHS clamp to stabilise the plate on the femur. The patients had a mean age of 81 years, surgery time of 43 minutes and hospital stay of 17 days. 77% were female and 35% required a blood transfusion post-operatively. Everyone was mobilised fully weight-bearing post-operatively. Follow-up was at six weeks for radiographic review and then subsequently at one year. The commonest complications were superficial wound infection (1.7%), detachment of the plate (0.9%) and cut-out of the lag screw (0.5%).